From Glasgow to Guyana
Sculpture celebrating Guyana in Georgetown
by Gabi Ott, SPAGN volunteer, who spoke with sarcoma surgeon Dr Sanjay Gupta.
One sarcoma surgeon on a medical mission
Sanjay Gupta is a man who is clearly used to multitasking. He agrees to meet me online after a clinic at the hospital and just before he has to rush off to the Christmas show of his little daughter. Since we don’t finish our interview on time, he switches from the computer to the mobile phone and continues talking while he walks.
Sanjay tells me about his mission work as an orthopedic surgeon. Once a year, he takes a one-week leave from his job and travels abroad to teach and operate in other countries. In line with his day job in the sarcoma center of the Glasgow Royal Infirmary, he focuses on sarcoma cases but also helps with metastatic tumor and general orthopedic cases including trauma.
Last October (2023), Sanjay was in Guyana and trained doctors at the Georgetown Public Hospital in the capital city. Dr Deepa Bose, a trauma surgeon of Guyanese origin now based in Birmingham, had heard about his sarcoma work and requested his input in Guyana, as she observed a big gap there in terms of sarcoma care. In fact, there is not a single tumor surgeon in the country! Due to the lack of public awareness and professional knowledge of sarcoma, late presentation of cases is common, says Sanjay. This in turn often results in patients seeking medical care for highly advanced and massive sarcoma tumors that are difficult to treat. In addition, indigenous populations often live quite remotely – a helicopter or plane ride away from the healthcare they need.
Scenes from Dr. Gupta's visit in Guyana. On the left, three other orthopedic specialists who travelled with him - Dr Deepa Bose (Birmingham trauma consultant), Dr Christina Kontoghiorghe (London resident), Dr Mansur Halai (Toronto trauma and foot and ankle consultant).
The key is education
In preparation of his mission to Guyana, Sanjay met the local team online and held virtual teaching sessions. In October 2023, he and three other specialists flew to Georgetown for a week. During his stay, he discussed around twenty sarcoma cases with the local team. The hospital orthopedic department has four consultants as well as about fifteen trainee surgeons and he provided guidance for two sarcoma operations on-site. In addition, he also helped with other cases. “I do not think there’s a bigger thing that I can do as an individual than train somebody to become a sarcoma specialist in Guyana,” says Sanjay.
Guyana is a small country with a population of about 800,000 inhabitants, but Sanjay had experienced similar challenges in a much bigger country. In 2017 and 2018, he visited Ethiopia, and learned there wasn’t a single sarcoma surgeon in the entire country of 120 million inhabitants. When he arrived at the Black Lion Hospital in the capital of Addis Ababa, about fifty patients with sarcoma were waiting in the outpatients department for assessment and treatment. Sanjay got down to work and operated all day, every day, the whole week. While he prefers to teach, there was just nothing else he could do other than to help these desperate people.
He also trained Ethiopian doctors, and one of them who had an interest in sarcoma surgery eventually became his fellow in Glasgow for two years. Thereafter, he returned to Ethiopia to help set up a national sarcoma service. As a result, there is now a surgeon specialized in sarcoma in Ethiopia! “My hope is that he can train others and then they can build a network. You really need at least two surgeons to support each other with what is ultimately quite stressful work,” says Sanjay.
It is impressive, but I wonder: How are these missions organized and funded? Sanjay has done six of them so far. Most are private volunteer initiatives, like in Guyana. The hospital in Georgetown provided accommodation for the team of consultants. Sanjay’s medical insurance includes indemnity for one charitable trip per year. The UK-based charity World Orthopedic Concern supported the team and provided £500 to cover part of the travel costs. The rest is self-funded from his own pocket. The absence from his paid job is his private/annual leave.
"I will not sit here and say I cannot afford it."
Next year, he is planning to return to Guyana to deliver a course on sarcoma in the summer. So far, he has not yet confirmed how that will be funded. If costs were covered, that would be great. But one thing is clear to him: “I will not sit here and say I cannot afford it.”
I am so impressed by his volunteer commitment to give his time and money, but also to take the risks that come along with such missions. I want to know what could be done to upscale and fund such initiatives. How can we reach out to other countries and provide sarcoma expertise?
“Maybe you at SPAGN could help me answer this question? This is of course a two-way street. Funding and time to go abroad would no doubt help and maybe attract more of my colleagues to get involved. Equally, local teams in developing nations must have a desire to develop their sarcoma/tumor service. Only then can a relationship be forged and ideally a service established to improve sarcoma care for all across the world.”
And off he goes to the Christmas show of his daughter.
Season’s Greetings!
Bio: Sanjay Gupta is an orthopedic oncology surgeon living and practicing in the west of Scotland. He is based at the Glasgow Royal Infirmary and the Nuffield Health Glasgow Hospital. He first became interested in sarcoma work during his training and has since then developed his expertise during different job postings and fellowships in Scotland and abroad. What he likes about his work is that it is varied -- from an orthopedic oncology point of view -- as he operates on all parts of the body. He finds patient interactions extremely rewarding and feels he really can make a difference for people with sarcoma. Sanjay is member of the Scottish Sarcoma Network.
That is amazing work. I hope the tumour networks could all get behind Sanjay in the way the a British Hand Society has got behind projects abroad. It would be good if Sanjay could get the same kind of sponsorship and support…#handinhand with Ukraine.